Systemic Lupus Erythematosus

Definition

Systemic lupus erythematosus (SLE) is an autoimmune disorder that causes inflammation of joints, tendons, skin, blood vessels and other connective tissue, and organs. SLE causes the immune system to produce antibodies that attack the body's healthy cells and tissue.
There are several forms of lupus, but SLE is the most common and most well-known.

Causes

The cause of SLE is unknown. It is likely due to a combination of genetic and environmental factors, such as viral infections or chemicals.

Flares of lupus can be triggered by:

Ultraviolet rays from the sun or high intensity fluorescent light bulbs

Certain drugs

Infection or injury

Physical or emotional stress

Risk Factors

SLE is more common in women aged 20-45 years old. It is also more common in people of African American, Native American, and Hispanic descent.

Symptoms

Symptoms can be mild or very severe. For some people, only part of the body, such as skin, is affected. For others, many parts are affected. Though symptoms can be chronic, there are usually periods of remission between flare-ups.

Common symptoms may include:

Headaches

Extreme fatigue

Swollen and/or painful joints

Fever without signs of infection

Weight loss

Skin rashes over areas exposed to sunlight, especially butterfly shaped rash over the nose and cheeks

Skin—may become sensitive to light, have hives, or red or purple rashes, or have hair loss

Muscles—may become stiff and weak

Gastrointestinal—may cause nausea, vomiting, or abdominal pain

Heart and lungs—may cause trouble breathing or chest pain

Brain and nerves— may lead to psychiatric disorders, such as depression, seizures, and nerve pain and numbness

Glands—may cause swollen nodes or spleen

Blood—may result in anemia, bleeding, or blood clots

SLE may cause complications during pregnancy. There may be a flare-up of symptoms, kidney problems, or
pre-eclampsia. There is also an increased risk of
premature birth,
stillbirth,
miscarriage, or growth problems with the baby during pregnancy.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis is based on specific diagnostic criteria related to your signs and symptoms. Your doctor will also rule out other health conditions that have symptoms similar to SLE. It may take some time to gather all the necessary information for a diagnosis.

Some tests include:

Blood tests—specific tests may be positive with lupus

Urine tests—to look for kidney damage

Skin biopsy

Kidney biopsy—to diagnose type of kidney disease, if you have kidney damage

Treatment

SLE is not curable, but it can be managed with medications and lifestyle changes. You may also need treatment for
issues
caused by SLE.

Talk with your doctor about the best treatment plan for you. Treatment options depend on the severity and location of your symptoms.

Medication

There are many different kinds of medications that are used to treat SLE. Examples include:

Antimalarial drugs—if no major organs are involved

Corticosteroids

Drugs to suppress the immune system

Nonsteroidal anti-inflammatory drugs (NSAIDs)—only if you have no stomach symptoms

B-cell therapy

Anticoagulants—in those at risk for blood clots

Your doctor may recommend that you take a combination of medications.

Preventing Flare-ups

Some lifestyle changes can help you prevent flare-ups of SLE. Lower doses of antimalarial drugs, corticosteroids, and drugs to suppress the immune system may also be used to prevent flares. Work with your doctor to create a plan for your symptoms.

Learn the signs of a flare-up and contact your doctor as soon as possible

Get immediate treatment for any cuts or infections

Manage symptoms for other chronic conditions caused by SLE

Avoid sun exposure

If you smoke, learn how to quit

Eat a healthy diet

Limit emotional stress

Get enough rest

Exercise regularly, with your doctor's permission

Chronic Care

Chronic conditions liks SLE are best managed with strong communication between you and your healthcare team. Make sure to go to all appointments as recommended. Let your doctor know about any changes in your health or care program.

Depression in people with chronic health conditions like SLE is common, emotional support is important. Surround yourself with supportive family and friends. If you are still having problems, consider counseling or joining a support group.

Prevention

There are no current guidelines to prevent SLE since the cause is not known.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.